CN108568031A - The stimulation diathermy controlled using autonomic nerves system - Google Patents

The stimulation diathermy controlled using autonomic nerves system Download PDF

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Publication number
CN108568031A
CN108568031A CN201810343285.7A CN201810343285A CN108568031A CN 108568031 A CN108568031 A CN 108568031A CN 201810343285 A CN201810343285 A CN 201810343285A CN 108568031 A CN108568031 A CN 108568031A
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difference
value
time
exponential quantity
curve
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史里尼·纳格希沃
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Dyansys Inc
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Dyansys Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
    • A61B5/4035—Evaluating the autonomic nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/024—Detecting, measuring or recording pulse rate or heart rate
    • A61B5/02405—Determining heart rate variability
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/36017—External stimulators, e.g. with patch electrodes with leads or electrodes penetrating the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4821—Determining level or depth of anaesthesia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4887—Locating particular structures in or on the body
    • A61B5/4893—Nerves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36053—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for vagal stimulation
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

The present invention discloses the method and system for the dysautonomia state in order to look after patient analysis's autonomic nerves system.In some embodiments, the method includes measuring the root of autonomic nerves system situation and calculated value summation.One or more values are equal to the summation for the difference for being increased to index, and the difference is respectively equal to the difference of the first exponential quantity and the second exponential quantity.First exponential quantity and second exponential quantity are each based on the autonomic nerves system situation to calculate.This method further includes that the expression of calculated root is shown by display unit.

Description

The stimulation diathermy controlled using autonomic nerves system
This case is the divisional application of following patent application：
Application number：201380077463.1；
The applying date：On June 13rd, 2013；
Denomination of invention：The stimulation diathermy controlled using autonomic nerves system
Cross reference to related applications
This application involves entitled " the EXTRACTING CAUSAL INFORMATION authorized on the 15th of August in 2006 The United States Patent (USP) No.7,092 of FROM A CHAOTIC TIME SERIES (from chaos time sequence extraction cause and effect information) ", 849, which is herein incorporated by reference.Present patent application is related to the application submitted simultaneously：It is entitled “METHOD AND APPARATUS FOR AUTONOMIC NERVOUS SYSTEM SENSITIVITY-POINT TESTING US patent application attorney's files No.89562- of (method and apparatus for the test of autonomic nerves system sensitive spot) " 000400US-874044, entitled " (computer is real by COMPUTER IMPLEMENTED TRAINING OF A PROCEDURE The procedural training applied) " US patent application attorney's files No.89562-000500US-874022 and entitled " METHOD The generation of AND APPARATUS FOR STIMULATIVE ELECTROTHERAPY (for stimulating diathermic method and apparatus) " People's files No.89562-001000US-876815 is managed, the entire contents of above-mentioned all patents are incorporated herein by reference.
Technical field
In general, the present invention relates to a kind of chaos time sequence data generated from the autonomic nerves system based on patient The method and apparatus of middle extraction information, and use the information to the treatment that patient is given in enhancing.More precisely, the present invention relates to A kind of method and apparatus for analyzing pretherapy and post-treatment patient's states.
Background technology
Autonomic nerves system (ANS) has sympathetic nerve and parasympathetic nerve subsystem, dominates myocardium and body each The involuntary action of a internal organs.ANS is to cannot directly enter autonomous control.On the contrary, it with from master mode autonomic reflex in The basis of pivot control is operated.One of its major function is the stable state maintained in body.ANS is also around organism and its Serve in the interaction of environment adaptive.
It is to estimate the powerful measure of influences of the ANS to cardiac system that heart rate volatility measurement, which has been displayed,.Therefore, heart rate volatility is The strong indicator of ANS states, and may be used as the state of assessment and the relevant physiological conditions of ANS, such as chronic ache.
In many diseases, the sympathetic nerve and/or parasympathetic nerve subsystem of ANS all can be affected, to lead Cause dysautonomia.Therefore, the reliable and representational measurement of the activity with ANS and state is important.
The main method of three classes from heart rate volatility for obtaining the related information of ANS：Spectrum analysis (also referred to as time domain point Analysis), the statistics of Correlation Dimension (or any relevant dimension) and calculating.These methods do not provide the result for being easy explanation.This Outside, they lack reliability, and are often mathematically unsuitable for the application that they are considered.
It, only can controlling with subjective measurement particular condition in the case of not to the reliable and representational measurement of ANS Therapeutic effect.For example, in order to measure the pain of patient, it may inquire that patient to estimate their pain degree according to 1-10 points.
In general, the present invention relates to a kind of method and apparatus for extracting cause and effect information from chaos time sequence.More It speaks by the book, the present invention relates to a kind of method and apparatus for analyzing the state of the first system from time varying signal, when described Varying signal represents the chaos series of the time interval between the quasi periodic event that the second system dominated by the first system generates. In the typical but non-exclusive application of the present invention, the first system is autonomic nerves system (ANS), and second system is the heart Dirty system.
It is the powerful measure for estimating influences of the ANS to cardiac system that heart rate volatility, which has been displayed, and measures (HRV).In fact, ANS has sympathetic nerve and parasympathetic nerve subsystem, dominates the involuntary action of each internal organs of cardiac muscle and body.
ANS is to cannot directly enter autonomous control.On the contrary, it with from master mode on the basis that autonomic reflex and maincenter control It is operated.One of its major function is the stable state maintained in body.ANS is also in the phase interaction of organism and its ambient enviroment Serve in adaptive.
In many diseases, the sympathetic nerve and/or parasympathetic nerve subsystem of ANS all can be affected, to lead Cause autonomic imbalance.Therefore, the reliable and representational measurement of the activity with ANS and state is important.
The main method of three classes from heart rate volatility for obtaining the related information of ANS：Spectrum analysis (also referred to as time domain point Analysis), the statistics of Correlation Dimension (or any relevant dimension) and calculating.These methods do not provide the result for being easy explanation.This Outside, they lack reliability, and are mathematically unsuitable for the application that they are considered.
Invention content
One creative aspect is a kind of method of the dysautonomia state of analysis autonomic nerves system.It is described Method includes measuring the root of autonomic nerves system situation and calculated value summation.One or more values are equal to the difference for being increased to index The summation of value, and the difference is respectively equal to the difference of the first exponential quantity and the second exponential quantity.First exponential quantity and described Second exponential quantity is each based on the autonomic nerves system situation to calculate.This method further includes being shown by display unit Show the expression of calculated root.
Be a kind of in terms of another creativeness is for analyze the dysautonomia state of autonomic nerves system System.The system includes the device for measuring autonomic nerves system situation, and the root for calculated value summation device, wherein One or more values are equal to the summation for the difference for being increased to index.The difference is respectively equal to the first exponential quantity and the second exponential quantity Difference, and first exponential quantity and second exponential quantity are to be each based on the autonomic nerves system situation to calculate 's.The system further includes the device of the expression for showing calculated root by display unit.
It is proposed that one kind is used for it is an object of the invention to make up the disadvantages mentioned above of the prior art, and in order to reach this effect The method that the state of the first system is analyzed from time varying signal, the time varying signal are represented in the second system dominated by the first system The chaos series of time interval, the described method comprises the following steps between the quasi periodic event generated of uniting：Believe from the time-varying Extract envelope information in number, structure is for the phase space of the time varying signal, when extracting about with described in the phase space The relative position information of the corresponding point of varying signal combines the envelope information and the location information, based on this combination, carries For the information about the first system state.
Therefore, the present invention using time varying signal fractals and be combined with envelope interpretative version and in phase space reconstruction The estimation of the dispersion at midpoint.Present invention has found that when dismissing inapparent variation, such combination can be emphasized in time interval Chaos sequence in significant change, to provide about the first modeling state accurate information.
Meter can be passed through in the present invention to the more vibrant and reactive response of the variation in the first system state Two envelopes of evaluation time intervening sequence obtain, i.e., the first coenvelope for being calculated on the direction of time sequencing and with the time The second coenvelope calculated on sequentially opposite direction.
The present invention also makes to distinguish the sympathetic god of ANS by two kinds of calculations defined in the attached claim It is possibly realized through subsystem and parasympathetic nerve subsystem, to describe moment state in each of these subsystems.
Other favorable characteristics according to the method for the present invention limit in accompanying independent claim.
The invention further relates to the computer programs and equipment for executing method mentioned above.
The present invention provides a kind of method for analyzing the state of the first system from time varying signal, the time varying signals Represent the chaos series of the time interval between the quasi periodic event that the second system dominated by the first system generates, the side Method includes the following steps：
A) envelope information is extracted from the time varying signal,
B) structure is directed to the phase space of the time varying signal,
C) relative position information of the extraction about point corresponding with the time varying signal in the phase space,
D) envelope information and the location information are combined,
E) it is based on this combination, the information about the first system state is provided.
Preferably, when new time interval, which appears in, to be occurred in the time varying signal, repeating said steps q) is to e).
Preferably, wherein the step a) includes calculate the time varying signal on the direction of the time sequencing One coenvelope, and calculate in the second coenvelope with the time varying signal in the time sequencing opposite direction.
Preferably, wherein the step b) include use between dimension and identified time determined by the phase space It is interposed between by building vector on the basis of the time varying signal value.
Preferably, wherein the step c) includes by the point corresponding with the time varying signal in the phase space Project in relatively low dimension space, orbution can be established in the relatively low dimension space, and calculate the subpoint it Between distance.
Preferably, wherein the step c) includes by the point corresponding with the time varying signal in the phase space It projects on straight line, the straight line minimizes the average distance between the point and the straight line, and calculates the subpoint The distance between.
Preferably, wherein the step c) further includes positive distance and the negative distance identified in the distance calculated.
Preferably, wherein based on the positive distance or described negative apart from gauge index, the first system described in the exponential representation The state of system changes the probability for being happened at next event.
Preferably, wherein the step e) includes providing the described information in the first system state to display list Member.
Preferably, wherein the time varying signal is original signal.
Preferably, wherein the first system is autonomic nerves system.
Preferably, wherein the second system is cardiac system, the quasi periodic event is the R waves of electrocardiogram, described The chaos series of time interval is derived from the phase between the RR of the electrocardiogram.13. method according to claim 11 or 12, The wherein described step d) includes executing the first combinatorial operation and executing the second combinatorial operation, and first combinatorial operation provides representative First data of the parasympathetic nerve subsystem of the autonomic nerves system, second combinatorial operation are provided described in representative Second data of the sympathetic nerve subsystem of autonomic nerves system.
Preferably, wherein the step d) includes executing the first combinatorial operation for providing the first data and executing to provide second Second combinatorial operation of data represents the parasympathetic nerve subsystem of the ANS and the sympathetic nerve subsystem from other Any point-by-point subtraction in these first data and the second data of balance between system.
Preferably, further include calculating the first of the complex exponent for representing the first curve limited by first data to refer to Number, and/or calculate the second index of the complex exponent for representing the second curve limited by second data.
Preferably, wherein the first system is autonomic nerves system, the step a) includes that calculating is suitable in the time First coenvelope ForwHull of the time varying signal on the direction of sequence, and calculate in the time sequencing opposite direction The second coenvelope BackwHull, the step c) of time varying signal when including by with described in the phase space On the corresponding spot projection to relatively low dimension space of varying signal, orbution can be established in the relatively low dimension space, counted Calculate the subpoint and the positive distance identified in the distance of the calculating and the distance between negative distance, and the step Rapid d) includes executing following two combinatorial operations：
Coeffinc 1=B+ (4-4A-5B+4AB)Cinc–B·Cdec
Coeffdec 1=B-BCinc+(4A–4AB–B)·Cdec
With
Wherein A and B is predetermined constant, and normcoeff is normalization coefficient, and Cinc and Cdec are to respectively represent positive distance With the vector of negative distance, and the described information provided wherein in the step e) includes vector ANSigram1With ANSigram2。
Preferably, wherein the step d) further includes calculating following two indexes：
Wherein Floor refers to integer part, if the parameter is negative value, Floor returns to zero, ANSlength1With ANSlength2It respectively refers to by the vector ANSigram1Limit the first length of a curve and by the vector ANSigram2 The second length of a curve limited, range1Refer to the difference between the last value of first curve and the first value, range2Refer to institute The difference between the last value of the second curve and the first value is stated, and N refers to equal to the vector ANSigram1And ANSigram2's The predetermined number of dimension.
The present invention also provides a kind of calculating for analyzing the state of the first system when being implanted into processor from time varying signal Machine program, the time varying signal represented between the quasi periodic event that the second system dominated by the first system generates between the time Every chaos series, the computer program includes the instruction code for executing any one of aforementioned schemes the method.
The present invention also provides a kind of equipment for analyzing the state of the first system from time varying signal, the time varying signals The chaos series of the time interval between the quasi periodic event that the second system dominated by the first system generates is represented, it is described to set Standby includes the processing unit being programmed to carry out according to any one of aforementioned schemes the method.
The present invention also provides a kind of equipment for analyzing the state of the first system from time varying signal, the time varying signals The chaos series of the time interval between the quasi periodic event that the second system dominated by the first system generates is represented, it is described to set It is standby to include：
Device for extracting envelope information from the time varying signal,
Device for building the phase space for being directed to the time varying signal,
Device for extracting the relative position information about point corresponding with the time varying signal in the phase space,
Device for combining the envelope information and the location information, and
Device for providing the information about the first system state based on this combination.
Preferably, the equipment further includes when appearing in the time varying signal new time interval, for repeating State the device of envelope information extraction, phase space structure, location information extraction, information merging and information providing step.
Preferably, wherein described for extracting the device of envelope information includes for calculating in the direction of the time sequencing On the time varying signal the first coenvelope device, and for calculate in the time sequencing opposite direction described in The device of second coenvelope of time varying signal.
Preferably, wherein the device for building the phase space includes being determined to the phase space for use Dimension and identified time interval built on the basis of by the time varying signal value vector device.
Preferably, wherein the device for extract part information include for by in the phase space described in Device on the corresponding spot projection to relatively low dimension space of time varying signal, order can be established in the relatively low dimension space Relationship, and the device for calculating the distance between described subpoint.
Preferably, wherein the device for extract part information include for by in the phase space described in Device on the corresponding spot projection to straight line of time varying signal, the straight line minimize flat between the point and the straight line Equal distance, and the device for calculating the distance between described subpoint.
Preferably, wherein the device for extract part information further includes for identification in the distance calculated The device of positive distance and negative distance.
Preferably, further include for based on the positive distance or the negative device apart from gauge index, the index table Show that the state of the first system changes the probability for being happened at next event.
Preferably, wherein described for providing the device of information includes for including in the first system by described information Display device in state.
Preferably, wherein the time varying signal is original signal.
Preferably, wherein the first system is autonomic nerves system.
Preferably, wherein the second system is cardiac system, the quasi periodic event is the R waves of electrocardiogram, described The chaos series of time interval is derived from the phase between the RR of the electrocardiogram.32. the equipment according to claim 30 or 31, The wherein described mixing device includes the device for executing the first combinatorial operation and the device for executing the second combinatorial operation, institute State the first data that the first combinatorial operation provides the parasympathetic nerve subsystem for representing the autonomic nerves system, described the Two combinatorial operations provide the second data of the sympathetic nerve subsystem for representing the autonomic nerves system.
Preferably, wherein the mixing device include for execute provide the first data the first combinatorial operation device and Device for executing the second combinatorial operation for providing the second data represents the parasympathetic nerve of the ANS from other Any point-by-point subtraction in these first data and the second data of balance between system and the sympathetic nerve subsystem.
Preferably, further include for calculating the complex exponent for representing the first curve limited by first data first The device of index, and/or the second index for calculating the complex exponent for representing the second curve limited by second data Device.
Preferably, wherein the first system is the autonomic nerves system, the envelope information extraction element includes using In the device for the first coenvelope ForwHull for calculating the time varying signal on the direction of the time sequencing, and calculate With the device of the second coenvelope BackwHull of the time varying signal in the time sequencing opposite direction, the position letter Breath extraction element includes for by the spot projection corresponding with the time varying signal in the phase space to relatively low dimension Device spatially can establish orbution, the device for calculating the subpoint and use in the relatively low dimension space In the device for calculating the distance between the positive distance identified in the distance of the calculating and negative distance, and the combination Device includes the device for executing following two combinatorial operations：
Coeffinc1 =B+ (4-4A-5B+4AB)Cinc–B·Cdec
Coeffdec 1=B-BCinc+(4A–4AB–B)·Cdec
With
Wherein A and B is predetermined constant, and normcoeff is normalization coefficient, and Cinc and Cdec are to respectively represent positive distance With the vector of negative distance, and the described information provided wherein in the step e) includes vector ANSigram1With ANSigram2。
Preferably, wherein the mixing device further includes the device for calculating following two indexes：
Wherein Floor refers to integer part, if the parameter is negative value, Floor returns to zero, ANSlength1With ANSlength2It respectively refers to by the vector ANSigram1Limit the first length of a curve and by the vector ANSigram2 The second length of a curve limited, range1Refer to the difference between the last value of first curve and the first value, range2Refer to institute The difference between the last value of the second curve and the first value is stated, and N refers to equal to the vector ANSigram1And ANSigram2Dimension The predetermined number of degree.
Preferably, further include device for obtaining event paracycle about patient.
Description of the drawings
Fig. 1 shows to look after the flow chart of the method for patient.
Fig. 2 shows the flow chart for the method for calculating dysautonomia, this method can make in the method for Fig. 1 With.
Fig. 3 shows that the flow chart of the method for the treatment of patient, this method can use in the method for Fig. 1.
Charts of the Fig. 4 based on the measurement feature of patient ANS for determining the parameter value used in the method for figure 3.
Fig. 5 shows the example of the difference collection of sequence.
Fig. 6 is flow chart according to the method for the present invention；
Fig. 7 and 8 is shown respectively, and as generic instance, how two different envelopes obtain from time varying signal, and one A envelope determines that another envelope determines on the direction opposite with time sequencing on the direction of time sequencing；
Fig. 9 schematically illustrates the example of the phase space obtained in the method according to the invention；
Figure 10 shows the time varying signal of phase between RR of the representative from electrocardiogram；
Figure 11 shows the overlapping of the curve by obtaining according to the method for the present invention, and each representative is considered as ANS's State at the time of parasympathetic nerve subsystem；
Figure 12 is shown by the time change of two indexes obtained according to the method for the present invention；
Figure 13 shows the time change of another index by obtaining according to the method for the present invention；
Figure 14 is the flow chart for the system realized in the method according to the invention.
Figure 15 is the flow chart of the method according to another embodiment of the present invention for generating trimming trajectory.
Figure 16 is the figure of state table according to an embodiment of the invention.
The rotation of Figure 16 curve graphs of Figure 17 according to another embodiment of the invention and standardized curve figure.
Figure 18 a and Figure 18 b show two trimming trajectories of two continuous time intervals according to the ... of the embodiment of the present invention.
Figure 19 shows two trimming trajectories of connection figure 18a and Figure 18 b.
Figure 20 shows the rotation according to an embodiment of the invention in multiple time intervals and normalizes being averaged for state table The curve graph of the norm of coordinate and point.
Figure 21 shows the curve graph of the static equilibrium point in rotation and normalized coordinates system.
Figure 22 shows the curve graph of the time change for two indexes that method according to another embodiment of the present invention obtains.
Figure 23 is the flow chart of the method for the coupling between determining index according to an embodiment of the invention.
Figure 24 shows the flow chart of the filter according to an embodiment of the invention for being filtered to input signal.
Specific embodiment
Specific embodiments of the present invention are illustrated below in conjunction with attached drawing.
Various details when showing to be related to some embodiments in text.However, the present invention can also be described herein to be different from Those of mode realize.Without departing from the present invention, those skilled in the art can to the embodiment that is discussed into Row modification.Therefore, the present invention is not limited to specific embodiments disclosed herein.
Particular organisms event caused by patient is dominated by the ANS of patient.Therefore, the ANS situations of patient can pass through generation The appropriate of the data of table particular event is analyzed to determine.Further, since the ANS situations of patient can seek treatment with patient One or more conditions are related, and the analysis for representing the data of biological event can be used as the quantitative measurment of one or more conditions.
For example, biological event can be related with the cardiac system of patient.Therefore, the data of Heart Rate or heart rate volatility are represented It can be used for determining the measurement of the pain of patient experience.Alternatively or additionally, biological event can be with the respiratory system of patient or big Cerebration is related.
In some embodiments, include in chronic ache, anxiety, depression and sleeping problems with the associated illness of biological event It is one or more.
Fig. 1 shows to look after the flow chart of the method 100 of patient.Patient can be directed to can be by analyzing and patient's ANS dominations The relevant data of biological event seek to treat come the one or more illnesss measured.For example, patient may undergo chronic ache.
According to method 100, before treatment, dysautonomia and sympathetic vagus nerve balance are determined.In addition, treatment Afterwards, dysautonomia and sympathetic vagus nerve balance are determined again.At pre-treatment and after treatment, patient's autonomic nerve work( It can obstacle and the sympathetic poor instruction that can be used as therapeutic efficiency for being confused equilibrium valve.
In step 110, dysautonomia is determined.
In some embodiments, one or more methods described in annex 1 and/or system are for determining autonomic nerve work( It can obstacle.For example, using the data of the recordable biological event for representing patient's generation of the device described in annex 1, by patient ANS dominate.In addition, the one or more data analysing methods and system described in annex 1 can be used for based on the life recorded Object event data calculates the dysautonomia of patient.
In some embodiments, not the method described in annex 1 and/or system can also be used for calculate patient autonomous god Through dysfunction.It is, for example, possible to use below with reference to the method for determination patient's dysautonomia described in Fig. 2.
In the step 120, sympathetic vagus nerve balance is determined.
In some embodiments, one or more methods described in annex 1 and/or system can be used for determining that sympathetic fan walks Nerve balance.For example, using the number of device and/or the recordable biological event for representing patient's generation of method described in annex 1 According to by the ANS dominations of patient.In addition, the one or more data analysing methods and system described in annex 1 can be used for being based on The biological event data recorded balance to calculate the sympathetic vagus nerve of patient.In some embodiments, for calculating patient The biological event data that dysautonomia is recorded can also be used for calculating the sympathetic vagus nerve balance of patient.
In some embodiments, sympathetic using one or more method and system calculated equilibrium curves described in annex 1 Vagus nerve balances one or more parameters based on being extracted from the profile of equilibrium to determine.For example, horizontal axis or longitudinal axis value are most One or more of small value, maximum value, midrange, average value and intermediate value, which can be used as, makees sympathetic vagus nerve balance use.It can The maintenance of selection of land or alternatively, the appearance of cycle or long flat conversion can be used as sympathetic vagus nerve balance.
In some embodiments, not the method described in annex 1 and/or system can also be used for calculate patient sympathetic fan Walk nerve balance.
In step 130, patient is treated.In some embodiments, treatment is including being selected on patient body Position provide electro photoluminescence.It is alternatively possible to carry out one or more treatments to patient.For example, physiotherapy, other forms Stimulation, operation and anodyne, such as opium drug.
In some embodiments, the method below with reference to the treatment patient described in Fig. 3 can be used.
In step 140, after treatment, the sympathetic vagus nerve balance of patient is determined again.Can will after treatment determined by Sympathetic vagus nerve balance is compared with identified sympathetic vagus nerve balance before treatment.This, which relatively can be used for judging, controls Treat effect.
In some embodiments, in step 140, using generally identical as the system and method used in step 120 System and method come determine patient sympathetic vagus nerve balance, with determine treat before patient sympathetic vagus nerve balance. In some embodiments, it is used to determine the method and system of the sympathetic vagus nerve balance of patient after treating in step 140 not It is same as being used to determine the method and system of the sympathetic vagus nerve balance of the preceding patient for the treatment of in the step 120.
In step 150, after treatment, the dysautonomia of patient is determined again.Can will after treatment determined by Dysautonomia is compared with identified dysautonomia before treatment.This, which relatively can be used for judging, controls Treat effect.
In some embodiments, in step 150, using generally identical as the system and method used in step 110 System and method determine the dysautonomia of patient, with determine treat before patient dysautonomia. In some embodiments, it is used to determine the method and system of the dysautonomia of patient after treating in step 150 not It is same as being used to determine the method and system of the dysautonomia of the preceding patient for the treatment of in step 110.
In some embodiments, the method for repeating Fig. 1.For example, the method for Fig. 1 can use in the first treatment stage.Make It, can be based on the dysautonomia after being treated with first before the first treatment and sympathetic fan for a part for the first treatment stage The comparison of neural equilibrium valve is walked come the effect of judging the first treatment.Equally, the method for Fig. 1 can use in the second treatment stage. It is similar with the first treatment stage, as a part for the second treatment stage, can based on before the second treatment and after the second treatment from The comparison of main neurological dysfunction and sympathetic vagus nerve equilibrium valve is come the effect of judging the second treatment.In some embodiments, Second treatment stage is included in about 1 after the first treatment stage, 2,3,4,5,6,7,8,9,10,11 or 12 minutes, in the first treatment About 1 after stage, 2,3,4,5,6,7,8,9,10,11 or 12 hours, about 1 after the first treatment stage, 2,3,4,5,6,7,8,9, 10,11 or 12 days, about 1 after the first treatment stage, 2,3,4,5,6,7,8,9,10,11 or 12 weeks, after the first treatment stage About 1,2,3,4,5,6,7,8,9,10,11 or December or after the first treatment stage about 1,2,3,4,5,6,7,8,9,10,11 or 12 years.
In addition, the dysautonomia and sympathetic vagus nerve that are determined as a part for the second treatment stage are put down Weighing apparatus value is carried out with the dysautonomia of the part as the determination of the second treatment stage and sympathetic vagus nerve equilibrium valve Compare.This comparison result may indicate that the therapeutic efficiency by multiple treatment stages.
Fig. 2 shows the flow charts for the method 200 for calculating patient's dysautonomia.For example, method 200 can be in Fig. 1 Shown in use in method 100.In some embodiments, method 200 shown in Fig. 2 is performed separately, and different from shown in Fig. 1 Method 100.In addition, the calculating autonomic nervous function different from method 200 shown in Fig. 2 can be used in method 100 shown in FIG. 1 The method of obstacle.
According to method 200, autonomic nerve work(is calculated by the biological event recorded data that patient ANS is dominated based on representing It can obstacle.
In step 210, the first Index A NSindexl and the second Index A NSindex2 is the side according to annex 1 Method and system calculate.In alternative embodiment, can be used different method and system calculate ANSindexl and ANSindex2.In some embodiments, may be in response to each of multiple continuous biological events calculate ANSindexl and ANSindex2.For example, in response to for example with each of a large amount of heartbeats of ecg measurement, calculate ANSindexl and ANSindex2.In some embodiments, may be in response to a series of each of 400 heartbeats calculate ANSindexl and ANSindex2.In some embodiments, may be in response to a series of each of 512 heartbeats calculate ANSindexl and ANSindex2.In some embodiments, the data of the heartbeat from certain quantity, such as 60 times, it can be used for calibrating, or be used for Other purposes.In some embodiments, heartbeat is continuous.
In a step 220, a series of differences (DV) are calculated.Each difference of the series is all based on as referred to step 210 Described ANSindexl and ANSindex2 values calculated in response to continuous biological event calculate.For example, in step 210 In, to each of continuous biological event, ANSindexl values and ANSindex2 values are calculated, and in a step 220, calculated each Difference between the ANSindexl values and ANSindex2 values of continuous biological event.The difference that all biological events calculate is constituted Difference collection.
For example, in some embodiments,
DVi=ANSindex2i–ANSindexli,
Wherein i is the index (index) at indicated number strong point.
In step 230, difference (DV) collection is ranked up.For example, can be from minimal difference to maximum difference to difference Collection is ranked up.In other embodiments, the second difference can be ranked up from maximum difference to minimal difference.
Fig. 5 shows the example of the difference collection of sequence.Difference is depicted in ordering, smaller difference is depicted in larger The left side of difference, and the distance for wherein arriving horizontal axis is corresponding with the difference each to sort.Fig. 5 also shows linear fit benchmark Line.
In step 240, the difference of sequence is assigned to different sections.For example, limiting four sections.Indicate A, B and C identifies the boundary between the adjacent interval of difference example collection shown in fig. 5.In this illustration, instruction A, B and C is respectively aligned to Difference 67,167 and 421.In some embodiments, the linear or second dervative based on sequence difference is come determination section.For example, every A section may include the difference for corresponding to the point that second dervative is less than threshold value.It in some embodiments, can be in by section Between determined to the replacement exchange of linear or cubic fits distance in partial linear or cubic fits and/or different threshold value.
Each section can be corresponding with the specific feature of patient ANS.For example, first and last section, upper and lower bound can The depth for corresponding respectively to autonomic nervous function changes state and surface transient variation, and almost linear intermediate space may indicate that independently The fusion permanent state of stable state.
In step 250, dysautonomia of the information indicated for calculating patient is concentrated in the difference of sequence. Various mathematical methods can be used.
For example, value Vr can be determined to each of four sections.In some embodiments, pass through the difference summation to section To determine the value in each section.Alternatively, being summed by the difference in the section to being increased to index to determine the value in each section.Example Such as, which can be 2,3,4,5 or other values.In some embodiments, which can not be integer, can be irrational number And/or can be negative.It, can be by summing the difference for being increased to quadruplicate section come really as a non-limiting example It is worth in each of the fixed section.
For example, in some embodiments,
Wherein i is the summation index for indicating the data point in the section, and n is that the data in the section are counted, and r is indicated The section.
In some embodiments, the special coefficient (c) in relative region will be multiplied by for the value in the section respectively.Example Such as, it can be multiplied by -8.2045 coefficient with the relevant value of first interval, can be multiplied by with the relevant value of second interval 1.769 coefficient can be multiplied by 0.90025 coefficient with the relevant value of 3rd interval, and can with the 4th relevant value in section It is multiplied by 1.903 coefficient.Alternatively, the coefficient for first interval can be equal to -9.215, it can for the coefficient of second interval Equal to -530,0.7 can be equal to for the coefficient of 3rd interval, and can be equal to 1.23 for four-range coefficient.It can be used His coefficient value.
In some embodiments, it sums to the value for being multiplied by each coefficient.It is asked in addition, each coefficient can will be multiplied by The value of sum adds constant C.For example, -2600 can be added the value for being multiplied by the summation of each coefficient.Alternatively, constant C can be equal to- 1650。
In some embodiments, coefficient value { a->- 8-2045, b->1.769 c->0.90025, d->1.903 offset ->- 2600 } it is used together with the relatively low sampling rate (for example, 300Hz) of input ECG signal, and coefficient value { a->- 9.215, b->- 530, c->0.7, d->1.23, offset->- 1650 } the relatively high sampling rate with input ECG signal is (for example, 600Hz Or 1.2kHz) be used together.
In order to calculate dysautonomia AD, the result of summation can be increased to index, which is equal to for determining With the inverse of the index of the relevant value in each section.
For example, in some embodiments,
Wherein i is to indicate the summation index in section, and n is interval number.
In some embodiments, indicate calculated dysautonomia value by image conversion be shown in based on On the relevant display of device for calculating dysautonomia.
Fig. 3 shows the flow chart of the method 300 for the treatment of patient.It is used in the method 100 that this method 300 can be shown in Fig. 1. In some embodiments, method 300 shown in Fig. 3 can be performed separately, and be different from method 100 shown in FIG. 1.In addition, Fig. 1 Shown in method 100 can be used different from method 300 shown in Fig. 3 treatment patient method.For example, physiotherapy, other Stimulation, operation and the anodyne of form, such as opium drug.
In method 300, by the point on electro photoluminescence patient skin so that autonomic nerves system sensitivity treats patient.
In the step 310, the position of autonomic nerves system sensitivity on patient skin is identified.Known for example, can refer to and have The graphical representation of the last part of the patient body of other sensitive spot.In some embodiments, which is used as with identification and applies The position of pin mark corresponds to.
In step 320, electro photoluminescence source generator is adjusted in order to provide stimulus signal appropriate.For example, one or more At least one of parameter, such as frequency, amplitude, DC biasings, power and duration for the treatment of can be programmed into electro photoluminescence source hair In raw device.In some embodiments, electro photoluminescence source generator is based on the value determined with the value calculated based on biological event data Come what is programmed.For example, can be used for really with the relevant one or more values of dysautonomia or sympathetic vagus nerve balance Fixed one or more values for the one or more parameters that will be incorporated into electro photoluminescence source generator.
For example, Fig. 4 shows the measurement feature based on patient ANS for determining the parameter value used in the method for figure 3 Chart.Specifically, Fig. 4 shows the chart that can be used for determining the setting power for electro photoluminescence source generator.In this example In, setting power can be determined based on relevant value is balanced with sympathetic vagus nerve.In this illustration, it is used compared with high setting power In higher calculated sympathetic vagus nerve equilibrium valve.Optionally or alternatively, similar chart can be used for based on measured Patient ANS features determine the other parameters for encoding electro photoluminescence source transmitter.
In a step 330, electro photoluminescence is provided on the position identified in the step 310.For example, can be identified each Site on be inserted into needle, and this needle is connected to electro photoluminescence source transmitter.In addition, circuit completion path, such as grounding path, are It is provided by the way that circuit completion path is connected to patient from electro photoluminescence source transmitter.Pass through the portion identified in the step 310 It is inserted into needle at position and provides electro photoluminescence to patient, the electro photoluminescence source generator ginseng of step 320 by electro photoluminescence source transmitter Numerical value encodes.
Although the present invention is by way of specific embodiment as described above come disclosed, these embodiments not purport In the limitation present invention.In terms of based on methods and techniques disclosed above, without departing from the spirit and scope of the present invention, Those skilled in the art can make alterations and modifications to the embodiment of presentation.
With reference to figure 6, a kind of method for analyzing ANS states includes the steps that S1 to S13.
In step sl, acquisition represent that the biosystem dominated by patient ANS generates paracycle event first time Variable signal or data.For example, the biosystem is the cardiac system, respiratory system or brain system of patient.Described first Time varying signal is original signal, i.e., non-smooth signal and non-filtered signals.Therefore, all modifications of this signal are all retained, Including miniature variation.
In step s 2, paracycle event of the detection in the first time varying signal, and calculate these paracycles event it Between time interval become " time interval signal " to form the second time varying signal or data, take by it is a series of counted when Between be spaced the centrifugal pump of composition.A series of these time varying signals are chaos.In a preferred embodiment of the invention, exist The time varying signal acquired in step S1 is the electrocardiogram (ECG) of patient, and the time interval calculated in step s 2 is the phase between RR, i.e., Interval between the R waves of electrocardiogram.Figure 10 is obtained in step s 2 in the case of showing the phase between such RR in the method for illustration The example of the time interval signal obtained.It is corresponding with the time interval of calculating in each of signal of Figure 10 point.Such signal It is known in the art that dividing shape.
In practice, S2 is executed in time, i.e., when being happened in the first time varying signal event, detects this event, and And calculate the time interval between this event and previous event.In an identical manner, whenever by the step S2 calculating times When interval, the algorithm formed by following steps S3 to S13 is executed.
In step s3, limiting time window W.The upper limit L of time window W1Correspond in time and in step s 2 calculates Final time interval.Setting time lower limit L0So that the width L of time window W1-L0Corresponding to the pre- of the time interval calculated Fixed number N.In other words, the time interval N-1 that window W covers the time interval of last (current) calculating and calculates before.It is predetermined Number N is determined and visual time scale corresponding to the wherein state of ANS.This number can be selected by user.Its acquiescence Value is, for example, 40.
In step S, two convex or coenvelopes of the time interval signal obtained in step s 2 are calculated in window W. One in various envelopes is calculated on the direction of time sequencing, and lower limit L is risen to from the lower limit of time window W1.Suitable with the time Sequence calculates another envelope on opposite direction, from upper limit L1It is down to lower limit L0, then reset in time sequencing.By general The arbitrary signal SIG for being given in window W is shown respectively in the mode of illustration, Fig. 7 and Fig. 8, such as on time sequencing direction The corresponding coenvelope calculated and the corresponding coenvelope calculated on the direction opposite with time sequencing.From these figures , it is evident that two envelopes are different, therefore contain different supplemental informations in the modification of signal SIG.It should be pointed out that giving The coenvelope of fixed signal f (t) is given by：
The coenvelope such as obtained in the step S4 of the present invention is individually the form of table or vector with N values, therein Each correspond to one in the centrifugal pump extracted by time interval signal.Corresponding to what is calculated on the direction of time sequencing The table of coenvelope will be regarded as ForwHull below, and corresponding to the upper packet calculated on the direction opposite with time sequencing The table of network is BackwHull below.
The series-parallel of step S5 to S10 is executed in step S4.Step S5 is essentially consisted between the volume time in window W Multidimensional phase space is built every signal section.The concept of phase space is known per se in mathematic(al) physics.For example, for mutually empty Between the scheme that builds and the reason of for this structure by Packard et al. Septembers in 1980 1 day in Physical Review In the paper of entitled " Geometry from a Time Series " on the 9th phases of Letters volume 45 and by Farmer etc. Entitled " the Predicting of people's August in 1987 24 days on Physical Review the 8th phases of Letters volume 59 Described in the paper of Chaotic Time Series ".The present invention follows said program, such as it is such, phase space in the following manner by Structure：From the value series taken by the time interval signal in window W, from lower limit L0To upper limit L1By X1、X2、X3...XNName, Vector, for example, three-dimensional, it is to be built using for example four-dimensional time interval or delay.Therefore, in general, primary vector will The first value X with the time interval signal in window W as its first component1, as its second component in window W In time interval signal the 5th value X5, and as the 9th value of its three-component time interval signal in window W X9.Secondary vector is by the second value X with the time interval signal in window W as its first component2With as its second With the 6th and the tenth value X of the three-component time interval signal in window W6Equal X10, etc..
Preferably, in order to obtain the value N of such vector, by the way that the vector finally completed is repeated to the greatest extent may be used in the end of sequence Vectorial series can repeatedly be completed.The vector obtained is listed as follows：
Although in a preferred embodiment of the invention, vectorial dimension, i.e., the dimension of phase space and time interval be respectively etc. In 3 and 4, these dimensions and time interval can be different.However, when such dimension and time interval be not likewise it is preferred that protect It holds their product and is equal to 12.
The vector obtained as described above respectively represents the point in phase space.The present invention it has been observed that the point of phase space not It is random distribution, but forms point set, each represents the common equilibrium state of ANS.It demonstrate,proves as an example, Fig. 9 The phase space obtained during the inclining experiment for imposing on patient is shown, inclining experiment is i.e. wherein by patient from horizontal position lever Prize the test (80 ° of angles) of quasi- upright position as can be seen, phase space includes two independent collection of point CL1, CL2.Point These one each corresponded in above-mentioned horizontal position and quasi- upright position concentrated of CL1, CL2.
Step S6 is to reduce the dimension of phase space, in order to obtain the location information about the point being relative to each other.Step S6 More specifically be the point of phase space, i.e., with the point of above-mentioned vector correlation, in rectangular projection to relatively low dimensional space, described Relatively low dimensional space, which is attended class, establishes orbution.In general, step S6 is by the spot projection to straight line of phase space, the straight line is minimum Change the average distance between these points and these straight lines.This passes straight through point set, as described in Figure 9 at reference numeral SL.This It can be obtained by conventional linear fitting process.The straight line provides orientation, can be arbitrarily selected single preferably according to most parallel with straight line Phase space axis select.
Once phase space volume all the points are projected on above-mentioned straight line, step S7 calculates the relative distance between subpoint, And in accordance with the time sequencing that these are put.Accurately, step S7 calculate in time sequencing first point (i.e. with primary vector or point (X1、X5、X9) relevant subpoint) and in time sequencing second point (i.e. with primary vector or point (X2、X6、X10) related Subpoint) the distance between, then calculate first point in time sequencing and thirdly between distance, then calculating The distance between first point and the 4th point in time sequencing, and so on.Then step S7 is calculated in time sequencing Second point and in time sequencing thirdly between distance, then calculate second point in time sequencing and the 4th point it Between distance, subsequently calculate the second point in time sequencing and the distance between the 5th point, according to this class support.Then step S7 Calculate the thirdly distance between the 4th point in time sequencing, then calculate in time sequencing thirdly with the 5th The distance between point, according to this class support.Therefore, step S7 calculates N (N+l)/2 distance.Due to providing the curve of projection straight line, point In in the projection straight line, these distances are positive or negative (value zero are considered, for example, as positive value).All these distances It is all set in table, and is arranged at wherein with the sequence for wherein calculating them.This table represents in multidimensional phase space Average distance between point set.
In step s 8, the positive distance calculated in the step s 7 and negative distance are distinguished.More specifically, the first table Tinc and Second table Tdec is created, and respectively includes the absolute value of positive distance and negative distance, in each in these tables Tinc, Tdec Value keep their the identical sequence of original table, i.e. time sequencing.Table Tinc, the Tdec created in step s 8 can have Different length.In step s 9, last (nearest) time location in each in table Tinc, Tdec is started from, is selected First intersection group of the N successive values with highest average average value is simultaneously maintained in table, and other values are discrete, thus by these The dimension of each in table is reduced to N.In addition, if one of these N value being maintained in table Tinc or Tdec is less than Predetermined value R, then substituting these values by the value before in the group of N values in corresponding table Tinc or Tdec.Predetermined value R It can be selected by user.This value R indicates the thing between the event in being considered the first time varying signal important to user The minimum change at part interval.Step S9 end obtain two tables will refer to below Cinc (table for including positive distance) and Cdec (table for including the absolute value of negative distance).
In step slo, table Cinc and Cdec is combined with coenvelope ForwHull and BackwHull, with provide about The information of state at the time of ANS.In order to reach this effect, real-time two different operations, referred to as CTl and CT2, under Face discloses：
CTl:
Coeffinc 1=B+ (4-4A-5B+4AB)Cinc–B·Cdec
Coeffdec 1=B-BCinc+(4A–4AB–B)·Cdec
Wherein A and B is predetermined constant, and in a preferred embodiment of the invention, it is to return that A and B, which are equal to 0.5, normcoeff, One changes coefficient.
Coeffinc 1·ForwHullIt is table Coeffinc1With the product item by item of ForwHull, and
Coeffdec 1·BackwHullIt is table Coeffdec1With the product item by item of BackwHull.
CT2:
Wherein A and B is the identical predetermined constant such as in CT1, and normcoeff is the identical normalization system such as in CT1 Number,Coeffinc2·ForwHullIt is table Coeffinc2With the product item by item of ForwHull, andCoeffdec2·BackwHull It is table Coeffdec2With the product item by item of BackwHull.
According to the present invention, the Table A NSigram that is as above obtained by operation CT11Represent the parasympathetic nerve subsystem of ANS State, and the Table A NSigram as above obtained by operation CT22Represent the state of the sympathetic nerve subsystem of ANS.Therefore, this hair The bright information not only provided about ANS states, but also the sympathetic nerve subsystem and parasympathetic nerve subsystem of ANS can also be recognized System.In practice, as will become apparent to below, Table A NSigram1And ANSigrani2Each of will be with connection table The form of the curve of point is presented to user.The shape of this curve will directly be judged by user.For example, smooth ANSigram1And ANSigram2Curve will indicate the hypoergia of ANS, however, observation, for example, persistently increasing in these curves The slope added will indicate the change of speed in a time interval, that is, in the case where the first time varying signal is ECG, indicate heart Movable change.User also would be possible to the form of these curves being compared with essence with the tracing pattern observed before Really identification influences the problem of patient.In addition, curve ANSigram1And ANSigram2In one from the point-by-point subtraction in another By to the observation balanced between one sympathetic nerve subsystem of user and parasympathetic nerve subsystem, this balance is by the application Inventor is the discovery that nonlinear.
In step s 11, the first Index A NSindex is calculated1For representing table or curve ANSigram1Complex exponent, And calculate the first Index A NSindex2For representing table or curve ANSigram2Complex exponent.When corresponding curve ANSigram1、ANSigram2When showing fluctuation respectively, Index A NSindex1、ANSindex2It is larger number respectively, And work as curve ANSigram1、ANSigram2When showing fuctuation within a narrow range respectively, Index A NSindex1、ANSindex2It is respectively Smaller number, i.e. almost straight line.
These indexes are usually calculated as Bouligand dimensions and are normalized to outside, such as in the following manner：
Wherein Floor refers to integer part, if the parameter is negative value, Floor returns to zero, ANSlength1With ANSlength2Respectively refer to curve ANSigram1Length and curve ANSigram2Length, range1Refer to curve curve ANSigram1Last value and the first value between difference, range2Refer to curve curve ANSigram2It is last value and the first value Between difference.
In step s 12, gauge index ANSirisk indicates curve ANSigram1And ANSigram2Shape The wind to change (i.e. in the case of ecg, at the next R waves detected) at next event in one time varying signal Danger and probability, it means that the probability that the state of ANS changes.This Index A NSirisk indicates the work of ANS in another way Traverse degree.The calculating of Index A NSirisk is especially existed based on one in the table Tine and Tdec obtained in step s 8 It is above-mentioned it is related with step S6 in the case of be based on table Tdec, wherein according to axis select projection straight line direction, this straight line It is most to be parallel to axis.This Index A NSirisk is typically determined in the following manner：First, it is determined that in table Tdec The number a1, a1 of value are more than predetermined quantity rstart, and in the number a2 of table Tdec intermediate values, a2 is more than rstart+1, in table Tdec intermediate values Number a3, a3 is more than rstart+2 ..., in the number a of table Tdec intermediate valuesrstop–ratart,rstop–ratartMore than arstop–ratartGreatly In rstop, wherein rstop is also predetermined value.Then, number a is calculatediWeighted average.
For determining that the preference relation of number rstart and rstop are provided below：
Rstop=Floor (- rstart+0.5 | RstCenter-3.95-1.43rstart |+RstCenter+16)
In step s 13, display curve ANSigram1And ANSigram2With Index A NSindex1、ANSindex2With ANSirisk.Preferably, the first time varying signal is also shown.Subsequently, which returns to step S2 for being adopted from patient Next event in the time varying signal of collection.
0 to 13 disclose the example using the result obtained according to the method for the present invention referring now to fig. 1.
Figure 10 shows to represent the signal of phase between the RR of healthy patients during 5 minute period.T at the time of this period0 And t1Between, inclining experiment is carried out to patient.As can be seen that speed change is happened at moment t0And t1Between RR between it is interim. However, in fact, once the generally reduction of signal is distinguishable, this speed change can be only in moment t0Afterwards a certain Time detects in RR blank signals.In the example in Figure 10, it has sent out from being observed that with the routine tests of conventional means Raw speed is known as t at the time of change2Moment, t2It is relatively close to moment t1.For certain patients, inclined test is also mentioned The clearly change for not always causing the speed of phase between RR is tested, therefore detection is made to become difficult.
Figure 11 is shown in moment t0And t1Between Head-up Tilt Test in the curve ANSigram that obtains1Superposition.These Each of curve is considered after beaing patient's heart or more specifically ANS pairs between determining RR after the phase " photography (photography) " of state at the time of sympathetic nerve component.In fig. 11, curve is darker, newer.It can be seen that Curve ANSigram1Shape in moment t0And t1Between quickly change, it means that be according to the method for the present invention have very much it is anti- Answering property.Because the form of this curve is it will be evident that therefore not needing scale, however length-width ratio is determined for display song Line.Figure 12 shows a series of Index A NSindex obtained during be generally noted above five minute period on same chart1With A series of Index A NSindex2.Index A NSindex1It is indicated by fork, ANSindex2It is indicated by rectangle.It is interesting that we Notice Index A NSindex1Increase when inclining experiment starts, and moment t1It is in abundant at 80 ° of positions in patient before Reach peak value, and in above-mentioned moment t2Between with usual manner even more fully observe peak value, and Index A NSindex2 It is slowly increased when inclining experiment starts, until the first peak value is fully located at moment t1Later.Therefore, Index A NSindex1It is quickly anti- It answers, and Index A NSindex2With slower reaction.Once patient has reached 80 DEG C of positions, Index A NSindex1Reduce, and Index A NSindex2It takes over and shows different waves.It is all these be currently known about sympathetic nerve and parasympathetic god Behavior through subsystem is completely consistent.In particular, the presence in the above-mentioned wave in Index A NSindex2 can pass through friendship The release of the catecholamine hormone of neural subsystem is felt to illustrate.
Figure 13 shows the differentiation of Index A NSirisk during be generally noted above 5 minute period.It can be seen that this index Substantially show the peak at the midpoint during the inclination between moment t0 and t1.In practice, it is not as in figure 13 illustrates Curve shown by, but Index A NSirisk can be in the form of measuring the mobile function as the time up and down Now give user.
Method as described above is usually executed by suitable program processor.As shown in figure 14, it is named by bibliography 1 Processor is connected to the output of collecting unit 2 via suitable interface (not shown).Collecting unit 2 and the electrode for being connected to patient 2a is connected, and executes analog to digital conversion to generate the first time varying signal for representing event paracycle.Collecting unit 2, example Such as, it is ECG units.Display unit 3 is connected to processor 1 to show by providing according to the method for the present invention as a result, such as Curve ANSigram1And ANSigram2, these curves ANSigram1And ANSigram2Between difference, Index A NSindex1 And ANSindex2, these Index As NSindex1And ANSindex2Historical record (referring to Figure 12) and/or Index A NSirisk And first time varying signal.
In practice, several embodiments are possibly used for being arranged with respect to one another unit 1,2,3.Implemented according to the firstth Example, processor 1 and display unit 3 are a part for laptop computer, such as via USB port, are connected to collecting unit 2.According to the second embodiment, processor 1 is a part for inserted electronic plate.According to third embodiment, processor 1, Collecting unit 2 and display unit 3 are a parts for autonomous device, further include main circuit board, printer, medium recorder (CD- ROM ...), battery etc..According to the 4th embodiment, processor 1 and display unit 3 are a part for handheld device, example Such as, for example, cellular phone, in Palm OS (registered trademark) equipment, PocketPC (registered trademark) equipment, any individual digital Assistant etc..
In addition, in some embodiments, between electrode 2a and collecting unit 2, collecting unit 2 and processor 1 it Between and/or the connection between processor 1 and display unit 3 can be wirelessly connected, such as Bluetooth (registered trademark) even It connects.
Can use in various applications present invention as described above, especially the assessment of ANS to about diagnosis process and In the case of prognosis process is expected, such as：
(1) dept. of cardiology：
Risk stratification (arrhythmia cordis, coronary heart disease, hypertension ...)
Dosing beta-Blocking agent
The instruction of the pace maker of patients with syncope
The Prognostic Factors of myocardial infarction
2) division of endocrinology：
Diabetes and level of significance estimation
The estimation of dysautonomia
3) department of anesthesia：
The better administration of anodyne and somnifacient
The detection of cardioprotective agent
It faints during backbone anesthesia and caudal anaesthesia dangerous assessment
4) gynemetrics and obstetrics：
Fetal monitoring, the unstable detection of fetus situation
5) Pain management and treatment：
Adjust the dosage of anodyne
It is coupled with PCA (Patient Controlled Analgesia)
Assess the pain of baby and children
6) sleeping disorders：
The detection of-SAS (sleep apnea)
7) heart transplant：
Detection is repelled
Assess the ANS regeneration of heart
Although the present invention is described in the context in ANS, very aobvious and easy for a person skilled in the art See, the principle of the present invention will be applied in the system more different than ANS, especially be different biosystem, if when Event in varying signal is quasi-periodic, and corresponding time interval series is chaos, i.e., weak to depend on primary condition.

Claims (14)

1. a kind of method of the dysautonomia degree of the pretherapy and post-treatment autonomic nerves system of analysis, the method includes：
Autonomic nerves system situation is being measured by predefining the continuous time point that interval type separates, wherein the autonomous god It is characterized in that through system status：The first exponential quantity at each of the continuous time point and the second exponential quantity, The treatment of moderate stimulation diathermy was applied within the scope of the time point；
The difference of first exponential quantity and second exponential quantity is obtained at each of the continuous time point；
The root of calculated value summation, wherein one or more values be equal to be increased to index difference summation to form module, The degree of the wherein described module estimation dysautonomia；
The expression of calculated root is shown by display unit；And
First exponential quantity and second exponential quantity are：
With
Wherein Floor refers to integer part, if the parameter is negative value, Floor returns to zero, ANSlength1And ANSlength2Point Do not refer to by the vector ANSigram1 the first lengths of a curve limited and by the vector ANSigram2Second limited is bent The length of line, range1Refer to the difference between the last value of first curve and the first value, range2Refer to second curve The finally difference between value and the first value, and N refers to equal to the vector ANSigram1And ANSigram2Dimension predetermined number.
Wherein：
Wherein：
ForwHull is the first coenvelope of the time varying signal on time sequencing direction,
BackwHull is the second coenvelope of the time varying signal on the direction opposite with time sequencing,
Coeffinc 1=B+ (4-4A-5B+4AB)Cinc–B·Cdec,
Coeffdec 1=B-BCinc+(4A–4AB–B)·Cdec,
With
With
Wherein A and B is predetermined constant, and normcoeff is normalization coefficient, and Cinc and Cdec are to indicate positive distance respectively and bear The vector of distance.
2. according to the method described in claim 1, the wherein described difference belongs to the subset of difference collection, and wherein when the difference When collection is sorted by the value within the scope of time point, the subset includes multiple differences of the continuous difference collection.
3. according to the method described in claim 2, the wherein described difference collection includes four subsets.
4. according to the method in claim 2 or 3, the boundary wherein between subset is the secondary inverse based on the difference collection Come what is limited.
5. method according to claim 1 to 4, wherein the index is described inverse.
6. wherein described is fourth root the method according to any one of claims 1 to 5,.
7. method according to any one of claim 1 to 6, wherein it includes measuring to measure the autonomic nerves system situation Heart rate over time, and interval of the wherein described predefined interval type between heartbeat twice.
8. a kind of system for analyzing the dysautonomia degree of autonomic nerves system, the system comprises：
Device for measuring autonomic nerves system situation in the continuous time point separated by predefined interval type, wherein The autonomic nerves system situation is characterized in that：The first exponential quantity and second at each of the continuous time point Exponential quantity, the treatment of moderate stimulation diathermy were applied within the scope of the time point；
Dress for the difference for obtaining first exponential quantity and second exponential quantity at each of the continuous time point It sets；
The device of root for calculated value summation, wherein one or more values are equal to the summation for the difference for being increased to index to be formed Module, wherein the degree of module estimation dysautonomia；With
Device for the expression for showing calculated root by display unit；
System, wherein first exponential quantity and second exponential quantity are：
With
Wherein Floor refers to integer part, if the parameter is negative value, Floor returns to zero, ANSlength1And ANSlength2Point Do not refer to by the vector ANSigram1Limit the first length of a curve and by the vector ANSigram2The second curve limited Length, range1Refer to the difference between the last value of first curve and the first value, range2Refer to second curve most Difference between value and the first value afterwards, and N refers to equal to the vector ANSigram1And ANSigram2Dimension predetermined number,
Wherein：
Wherein：
ForwHull is the first coenvelope of the time varying signal on time sequencing direction,
BackwHull is the second coenvelope of the time varying signal on the direction opposite with time sequencing,
Coeffinc 1=B+ (4-4A-5B+4AB)Cinc–B·Cdec,
Coeffdec 1=B-BCinc+(4A–4AB–B)·Cdec,
With
With
Wherein A and B is predetermined constant, and normcoeff is normalization coefficient, and Cinc and Cdec are to indicate positive distance respectively and bear The vector of distance.
9. system according to claim 8, wherein the difference belongs to the subset of difference collection, and wherein when the difference When collection is sorted by value, the subset includes multiple differences of the continuous difference collection.
10. system according to claim 9, wherein the difference collection includes four subsets.
11. system according to claim 9 or 10, the wherein boundary between subset be based on the difference collection it is secondary fall It counts to limit.
12. the system according to any one of claim 8 to 11, wherein the index is described inverse.
13. the system according to any one of claim 8 to 12, wherein described is fourth root.
14. the system according to any one of claim 8 to 13, wherein it includes surveying to measure the autonomic nerves system situation The heart rate of amount over time, and interval of the wherein described predefined interval type between heartbeat twice.
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